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Bernhard F Morrey - One of the best experts on this subject based on the ideXlab platform.
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low transcondylar Fractures of the Distal humerus results of open reduction and internal fixation
Journal of Shoulder and Elbow Surgery, 2014Co-Authors: Juan P Simone, Joaquin Sanchezsotelo, Philipp N Streubel, Bernhard F MorreyAbstract:Background This study presents the outcomes of low transcondylar Fractures of the Distal humerus treated by open reduction and internal fixation. Methods Between 1996 and 2010, 263 Distal Humeral Fractures were managed at our institution. Patients with a true low transcondylar Fracture treated by open reduction and internal fixation were included. Fourteen patients form the basis of this study. Fracture fixation was achieved through a triceps-sparing approach, a triceps tongue, or an olecranon osteotomy. Internal fixation was performed with parallel plates, orthogonal plates, a single lateral plate, or a single medial plate. The clinical outcome was measured with pain levels, range of motion, and the Mayo Elbow Performance Score. Radiographs at latest follow-up were assessed for union, delayed union, nonunion, and hardware failure. Results At most recent follow-up, 11 patients had no pain, 2 had mild pain, and 1 had moderate pain. The mean Mayo Elbow Performance Score was 85. The mean arch of motion was 95°. Complications included nonunion, delayed union, wound complications, deep infection, and heterotopic ossification. Discussion Stable internal fixation of low transcondylar Fractures is perceived as difficult to achieve because of the very small size of the Distal fragment. However, the results of our study indicate that internal fixation of low transcondylar Fractures of the Distal humerus is associated with a high union rate and satisfactory clinical results. Elbow arthroplasty does not need to be considered for most patients with a low transcondylar Distal Humeral Fracture.
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heterotopic ossification after surgery for Fractures and Fracture dislocations involving the proximal aspect of the radius or ulna
Journal of Bone and Joint Surgery American Volume, 2013Co-Authors: Antonio M Foruria, Bernhard F Morrey, Salvador Augustin, Joaquin SanchezsoteloAbstract:Background: The objectives of this study were to (1) determine the prevalence of heterotopic ossification after surgery for Fractures and Fracture-dislocations involving the proximal aspect of the radius or ulna, (2) identify risk factors associated with the development of heterotopic ossification in these injuries, and (3) characterize the severity and location of the heterotopic ossification and the associated range of elbow motion. Methods: From 2004 to 2008, 142 elbow Fractures and Fracture-dislocations involving the proximal aspect of the radius or ulna were treated surgically at our institution. Records and radiographs of 130 elbows with adequate follow-up were retrospectively reviewed to identify cases of heterotopic ossification, characterize the ectopic bone, and analyze associated risk factors. The most frequent injuries included olecranon Fractures, Monteggia Fracture-dislocations, and various combinations of Fractures of the radial head and coronoid with or without dislocation or subluxation. Results: Heterotopic bone was identified on the radiographs of forty-eight elbows (37%). Heterotopic ossification interfered with motion in twenty-six elbows (20%), and thirteen elbows (10%) underwent additional surgery to remove heterotopic bone with the goal of improving motion. Risk factors associated with the development of heterotopic ossification included elbow subluxation or dislocation at the time of presentation, an open Fracture, a severe chest injury, and a delay in definitive surgical treatment. Ectopic bone was preferentially located at the origin of torn soft-tissue structures or around Fracture sites, and it was particularly common around the posterior aspect of the ulna and the neck of the radius. Heterotopic ossification was classified on radiographs as hazy immature in twenty-two elbows, limited mature in eighteen, extensive mature in five, and a complete bone bridge in three. Heterotopic ossification was more common in patients with an associated Distal Humeral Fracture, radial head and coronoid Fractures with an associated elbow dislocation (terrible triad injury), and a transolecranon Fracture-dislocation. Conclusions: Thirty-seven percent of elbows treated surgically for Fractures involving the proximal aspect of the radius and/or ulna developed heterotopic ossification. In twenty percent of elbows, heterotopic ossification was associated with clinically relevant motion deficits. More severe heterotopic ossification was encountered in patients presenting with an associated Distal Humeral Fracture, terrible triad injury, transolecranon Fracture-dislocation, or Monteggia Fracture-dislocation. Patients with an open injury, instability, severe chest trauma, or delay in definitive surgical treatment had a higher prevalence of heterotopic ossification. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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primary total elbow replacement for Fractures of the Distal humerus
Operative Orthopadie Und Traumatologie, 2005Co-Authors: L P Muller, Pol Maria Rommens, Srinath Kamineni, Bernhard F MorreyAbstract:OBJECTIVE Achieving stability and pain-free function for osteoporotic intraarticular multifragmentary Fractures of the Distal humerus in elderly patients by primary total elbow replacement (TER). INDICATIONS Non-soft-tissue-attached fragments, poor-quality bone, where stable osteosynthesis is not attainable. Severely comminuted intraarticular closed type C Fractures according to the AO classification with multiple small bone/cartilage fragments. In case of degenerative joint diseases and/or previous surgery in rheumatoid patients also type A and B Fractures. High compliance, low demand, and old patient > 65 years. CONTRAINDICATIONS Type II or III Gustilo-Anderson open Fractures (primary irrigation and debridement). Preexisting infection, open wounds. Younger, high-demand or noncompliant patient. Paralysis of the biceps muscle. SURGICAL TECHNIQUE Supine positioning of patient. Triceps-sparing dorsal approach. Elevation of medial aspect of the triceps from posterior aspect of the humerus and capsula, reflecting the triceps in continuity with the ulnar periosteum and the forearm fascia. If removal of Distal part of the humerus, the triceps insertion can be left intact. Preparation of humerus: no reconstruction of multiFractured condyles; excavate bone from medial and lateral supracondylar ridges with burr. Preparation of ulna: remove tip of olecranon. Cemented Humeral and ulnar components. Bone graft interposition behind anterior flange of Humeral component. Resection of radial head and coronoid process, if impingement after trial reduction. Triceps reattachment transosseous through olecranon. POSTOPERATIVE MANAGEMENT No formal physical-therapy sessions. Avoid single-event weight lifting of > 5 kg and repetitive lifting of > 1 kg. Discourage playing racquets sports. RESULTS 49 acute Distal Humeral Fractures in 48 patients (average age: 67 years) were treated with TER. 43 Fractures were followed at an average of 7 years. According to the AO classification, five Fractures were type A, five type B, and 33 type C. The average flexion arc at follow-up was 24-131 degrees, the Mayo Elbow Performance Score averaged 93. Data of complications were obtained from records in all 49 patients. 32 of the 49 elbows had neither a complication nor any further surgery from the time of the index arthroplasty to the most recent follow-up evaluation. Ten additional operative procedures, including five revision arthroplasties, were required. The retrospective review supports recommendation for TER for the treatment of an acute Distal Humeral Fracture, when strict inclusion criteria are observed.
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Distal Humeral Fractures treated with noncustom total elbow replacement
Journal of Bone and Joint Surgery American Volume, 2005Co-Authors: Srinath Kamineni, Bernhard F MorreyAbstract:BACKGROUND: The purpose of this study was to review the cases of patients with a Distal Humeral Fracture that was treated with a noncustom total elbow arthroplasty. We hypothesized that, on the basis of the functional and clinical outcome, total elbow replacement is a reliable option for the treatment of elderly patients with a severe, comminuted Fracture of the Distal part of the humerus. METHODS: We retrospectively reviewed forty-nine acute Distal Humeral Fractures in forty-eight patients who were treated with total elbow arthroplasty as the primary option. The average age of the patients was sixty-seven years. Forty-three Fractures were followed for at least two years. According to the AO classification, five Fractures were type A, five were type B, and thirty-three were type C. The average age of the forty-three patients was sixty-nine years and the average duration of follow-up was seven years. Fourteen patients died during the review period. Postoperative clinical function was assessed with use of the Mayo elbow performance score, and anteroposterior and lateral radiographs made at follow-up examinations were reviewed. RESULTS: At the latest follow-up examination, the average flexion arc was 24° (range, 0° to 75°) to 131° (range, 100° to 150°) and the Mayo elbow performance score averaged 93 of a possible 100 points. Heterotopic ossification was present to some extent in seven elbows, with radiographic abutment noted in two. Thirty-two (65%) of the forty-nine elbows had neither a complication nor any further surgery from the time of the index arthroplasty to the most recent follow-up evaluation. Fourteen elbows (29%) had a single complication, and most of them did not require further surgery. Ten additional procedures, including five revision arthroplasties, were required in nine elbows; five were related to soft tissue and five were related to the implant or bone. CONCLUSIONS: Complex Distal Humeral Fractures should be assessed primarily for the reliability with which they can be reconstructed with osteosynthesis. When osteosynthesis is not considered to be feasible, especially in patients who are physiologically older and place lower demands on the joint, total elbow arthroplasty can be considered. This retrospective review supports a recommendation for total elbow arthroplasty for the treatment of an acute Distal Humeral Fracture when strict inclusion criteria are observed.
Michael D Mckee - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of total elbow arthroplasty for Distal Humeral Fracture results from a prior randomized clinical trial
Journal of Shoulder and Elbow Surgery, 2019Co-Authors: Niloofar Dehghan, Matthew J Furey, Laura A Schemitsch, Bill Ristevski, Thomas J Goetz, Emil H Schemitsch, Michael D MckeeAbstract:Background Total elbow arthroplasty (TEA) is a reliable treatment for elderly patients with comminuted intra-articular Distal Humeral Fractures. However, the longevity and long-term complications associated with this procedure are unknown. The objectives of this study were to examine long-term outcomes and implant survival in elderly patients undergoing TEA for Fracture. Methods Patients from a previously published randomized controlled trial of 42 patients in which TEA was compared with open reduction–internal fixation (ORIF) were followed up long term. Patients were aged 65 years or older with comminuted intra-articular Distal Humeral Fractures. Outcomes included patient-reported grading of function and pain, revision surgical procedures, and implant survival. Results Data were obtained for 40 patients, 15 treated with ORIF and 25 treated with TEA, with a mean follow-up period of 12.5 years for surviving patients and 7.7 years for deceased patients. The reoperation rate was 3 of 25 in the TEA group and 4 of 15 in the ORIF group (P = .39). Of the 25 patients with TEAs, only 1 required (early) revision arthroplasty; 7 were living with their original arthroplasty, and 15 died with a well-functioning implant in situ. Three were lost to follow-up. Conclusions TEA is an effective and reliable procedure for the treatment of comminuted Distal Humeral Fractures in the elderly patient. Our study reveals reliable implant long-term survival, with no patient requiring a late revision. For the majority of these patients, a well-performed TEA will give them a well-functioning elbow for life and will be the last elbow procedure required.
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functional outcome following surgical treatment of intra articular Distal Humeral Fractures through a posterior approach
Journal of Bone and Joint Surgery American Volume, 2000Co-Authors: Michael D Mckee, Emil H Schemitsch, Tracy L Wilson, Lucy Winston, Robin R RichardsAbstract:Background: While surgical repair is considered the standard of care of displaced intra-articular Distal Humeral Fractures, most investigators have assessed its results with use of surgeon-based and/or radiograph-based outcome measures. The purpose of our study was to determine the functional outcome of fixation of displaced intra-articular Distal Humeral Fractures with use of a standardized evaluation methodology consisting of objective testing of muscle strength and use of patient-based questionnaires (both limb-specific and general health-status questionnaires). Methods: We identified twenty-five patients (fourteen male and eleven female), with a mean age of forty-seven years, who had an isolated, closed, displaced, intercondylar, intra-articular Fracture of the Distal part of the humerus repaired operatively through a posterior approach and fixed with plates on both the medial and the lateral column. All patients returned for follow-up that included recording of a complete history, physical examination, radiographic examination, completion of both a limb-specific questionnaire (Disabilities of the Arm, Shoulder and Hand [DASH]) and a general health-status questionnaire (Short Form-36 [SF-36]), and objective muscle-strength testing. Results: The mean duration of follow-up was thirty-seven months (range, eighteen to seventy-five months). The mean flexion contracture was 25 degrees (range, 5 to 65 degrees), and the mean arc of flexion-extension was 108 degrees (range, 55 to 140 degrees). Significant decreases in mean muscle strength compared with that on the normal side were seen in both elbow flexion measured at 90 degrees (74 percent of normal, p = 0.01) and elbow extension measured at 45 degrees (76 percent of normal, p = 0.01), 90 degrees (74 percent of normal, p = 0.01), and 120 degrees (75 percent of normal, p = 0.01). The mean DASH score was 20 points, indicating mild residual impairment. The SF-36 scores revealed minor but significant decreases in the role-physical and physical function scores (p = 0.01 and 0.03, respectively) but no alteration of the mental component or mean scores. Six patients (24 percent) had a reoperation; three of them had removal of prominent hardware used to fix the site of an olecranon osteotomy. Conclusions: The surgical repair of an intra-articular Distal Humeral Fracture is an effective procedure that reliably maintains general health status as measured by patient-based questionnaires. Our study quantified a decrease in the range of motion and muscle strength of these patients, which may help to explain the mild residual physical impairment detected by the limb-specific outcome measures and physical function components of the general health-status measures.
David Ring - One of the best experts on this subject based on the ideXlab platform.
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articular osteotomy of the Distal humerus and excision of extensive heterotopic ossification
Injury-international Journal of The Care of The Injured, 2016Co-Authors: Aditya Gill, Jos J Mellema, Mariano E Menendez, David RingAbstract:Prior case series of corrective osteotomy of substantial intra-articular malunion after a Fracture of the Distal humerus described concomitant heterotopic ossification in a subset of patient, but only in mild forms. We present our experience in treating two patients with malunited articular Fractures of the Distal humerus with extensive heterotopic ossification and near ankylosis where the lateral articular fragments were encased in heterotopic bone. Although osteotomy of articular malunion after Distal Humeral Fracture along with excision of extensive HO is challenging and risky due to potential devitalization of the fragments, articular deterioration during the delay to osteotomy, and recurrence of heterotopic bone among other concerns, restoring articular congruity in these patients using articular Fracture fragments extracted from heterotopic ossification can lead to improved function of the elbow.
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compartment syndrome associated with Distal radial Fracture and ipsilateral elbow injury
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Raymond Hwang, Pieter Bas De Witte, David RingAbstract:Background: Forearm compartment syndrome is an uncommon sequela of Distal radial Fractures. This investigation tested the hypothesis that the risk of forearm compartment syndrome associated with an unstable, operatively treated Fracture of the Distal end of the radius is higher with a concomitant injury of the ipsilateral elbow. Methods: All patients who sustained an unstable Fracture of the Distal end of the radius and/or injury to the elbow (a Fracture of the proximal end of the radius and/or ulna, simple elbow dislocation, elbow Fracture-dislocation, or Distal Humeral Fracture) and were operatively treated at two level-I trauma centers over a five-year period were identified from a comprehensive database. The prevalence of compartment syndrome in a cohort with an isolated Distal radial Fracture and a cohort with a simultaneous Distal radial Fracture and elbow injury were compared. Results: Nine (15%) of fifty-nine patients who sustained a simultaneous ipsilateral Distal radial Fracture and elbow injury had forearm compartment syndrome develop compared with three (0.3%) of 869 patients with an isolated unstable Distal radial Fracture (p < 0.001, relative risk = 50). The average time from presentation to the development of compartment syndrome and subsequent fasciotomy was twenty-seven hours. Three of the nine patients with injuries to both the elbow and the wrist had a compartment syndrome develop after initial operative treatment of the injuries, requiring a return to the operating room for fasciotomy. Conclusions: Forearm compartment syndrome is a frequent complication of simultaneous unstable injuries to the elbow and the Distal end of the radius. Heightened vigilance for compartment syndrome is paramount in patients with this combination of injuries. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
Joaquin Sanchezsotelo - One of the best experts on this subject based on the ideXlab platform.
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low transcondylar Fractures of the Distal humerus results of open reduction and internal fixation
Journal of Shoulder and Elbow Surgery, 2014Co-Authors: Juan P Simone, Joaquin Sanchezsotelo, Philipp N Streubel, Bernhard F MorreyAbstract:Background This study presents the outcomes of low transcondylar Fractures of the Distal humerus treated by open reduction and internal fixation. Methods Between 1996 and 2010, 263 Distal Humeral Fractures were managed at our institution. Patients with a true low transcondylar Fracture treated by open reduction and internal fixation were included. Fourteen patients form the basis of this study. Fracture fixation was achieved through a triceps-sparing approach, a triceps tongue, or an olecranon osteotomy. Internal fixation was performed with parallel plates, orthogonal plates, a single lateral plate, or a single medial plate. The clinical outcome was measured with pain levels, range of motion, and the Mayo Elbow Performance Score. Radiographs at latest follow-up were assessed for union, delayed union, nonunion, and hardware failure. Results At most recent follow-up, 11 patients had no pain, 2 had mild pain, and 1 had moderate pain. The mean Mayo Elbow Performance Score was 85. The mean arch of motion was 95°. Complications included nonunion, delayed union, wound complications, deep infection, and heterotopic ossification. Discussion Stable internal fixation of low transcondylar Fractures is perceived as difficult to achieve because of the very small size of the Distal fragment. However, the results of our study indicate that internal fixation of low transcondylar Fractures of the Distal humerus is associated with a high union rate and satisfactory clinical results. Elbow arthroplasty does not need to be considered for most patients with a low transcondylar Distal Humeral Fracture.
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heterotopic ossification after surgery for Fractures and Fracture dislocations involving the proximal aspect of the radius or ulna
Journal of Bone and Joint Surgery American Volume, 2013Co-Authors: Antonio M Foruria, Bernhard F Morrey, Salvador Augustin, Joaquin SanchezsoteloAbstract:Background: The objectives of this study were to (1) determine the prevalence of heterotopic ossification after surgery for Fractures and Fracture-dislocations involving the proximal aspect of the radius or ulna, (2) identify risk factors associated with the development of heterotopic ossification in these injuries, and (3) characterize the severity and location of the heterotopic ossification and the associated range of elbow motion. Methods: From 2004 to 2008, 142 elbow Fractures and Fracture-dislocations involving the proximal aspect of the radius or ulna were treated surgically at our institution. Records and radiographs of 130 elbows with adequate follow-up were retrospectively reviewed to identify cases of heterotopic ossification, characterize the ectopic bone, and analyze associated risk factors. The most frequent injuries included olecranon Fractures, Monteggia Fracture-dislocations, and various combinations of Fractures of the radial head and coronoid with or without dislocation or subluxation. Results: Heterotopic bone was identified on the radiographs of forty-eight elbows (37%). Heterotopic ossification interfered with motion in twenty-six elbows (20%), and thirteen elbows (10%) underwent additional surgery to remove heterotopic bone with the goal of improving motion. Risk factors associated with the development of heterotopic ossification included elbow subluxation or dislocation at the time of presentation, an open Fracture, a severe chest injury, and a delay in definitive surgical treatment. Ectopic bone was preferentially located at the origin of torn soft-tissue structures or around Fracture sites, and it was particularly common around the posterior aspect of the ulna and the neck of the radius. Heterotopic ossification was classified on radiographs as hazy immature in twenty-two elbows, limited mature in eighteen, extensive mature in five, and a complete bone bridge in three. Heterotopic ossification was more common in patients with an associated Distal Humeral Fracture, radial head and coronoid Fractures with an associated elbow dislocation (terrible triad injury), and a transolecranon Fracture-dislocation. Conclusions: Thirty-seven percent of elbows treated surgically for Fractures involving the proximal aspect of the radius and/or ulna developed heterotopic ossification. In twenty percent of elbows, heterotopic ossification was associated with clinically relevant motion deficits. More severe heterotopic ossification was encountered in patients presenting with an associated Distal Humeral Fracture, terrible triad injury, transolecranon Fracture-dislocation, or Monteggia Fracture-dislocation. Patients with an open injury, instability, severe chest trauma, or delay in definitive surgical treatment had a higher prevalence of heterotopic ossification. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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complex Distal Humeral Fractures internal fixation with a principle based parallel plate technique
Journal of Bone and Joint Surgery American Volume, 2007Co-Authors: Joaquin Sanchezsotelo, Michael E Torchia, Shawn W OdriscollAbstract:BACKGROUND: Severe comminution, bone loss, and osteopenia at the site of a Distal Humeral Fracture increase the risk of an unsatisfactory result, often secondary to inadequate fixation. The purpose of this study was to determine the outcome of treating these Fractures with a principle-based technique that maximizes fixation in the articular fragments and stability at the supracondylar level. METHODS: Thirty-four consecutive complex Distal Humeral Fractures were fixed with two parallel plates applied (medially and laterally) in approximately the sagittal plane. The technique was specifically designed to satisfy two principles: (1) fixation in the Distal fragments should be maximized and (2) screw fixation in the Distal segment should contribute to stability at the supracondylar level. Twenty-six Fractures were AO type C3, and fourteen were open. Thirty-two Fractures were followed for a mean of two years. The patients were assessed clinically with use of the Mayo Elbow Performance Score (MEPS) and radiographically. RESULTS: Neither hardware failure nor Fracture displacement occurred in any patient. Union of thirty-one of the thirty-two Fractures was achieved primarily. Five patients underwent additional surgery to treat elbow stiffness. There was one deep infection that resolved without hardware removal and did not impede union. At the time of the most recent follow-up, twenty-eight elbows were either not painful or only mildly painful, and the mean flexion-extension arc was 99°. The mean MEPS was 85 points. The result was graded as excellent for eleven elbows, good for sixteen, fair for two, and poor for three. CONCLUSIONS: Stable fixation and a high rate of union of complex Distal Humeral Fractures can be achieved when a principle-based surgical technique that maximizes fixation in the Distal segments and stability at the supracondylar level is employed. The early stability achieved with this technique permits intensive rehabilitation to restore elbow motion. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. ORIGINAL ABSTRACT CITATION: “Complex Distal Humeral Fractures: Internal Fixation with a Principle-Based Parallel-Plate Technique” (2007;89:[961-9][1]). [1]: /lookup/volpage/89/961
Emil H Schemitsch - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of total elbow arthroplasty for Distal Humeral Fracture results from a prior randomized clinical trial
Journal of Shoulder and Elbow Surgery, 2019Co-Authors: Niloofar Dehghan, Matthew J Furey, Laura A Schemitsch, Bill Ristevski, Thomas J Goetz, Emil H Schemitsch, Michael D MckeeAbstract:Background Total elbow arthroplasty (TEA) is a reliable treatment for elderly patients with comminuted intra-articular Distal Humeral Fractures. However, the longevity and long-term complications associated with this procedure are unknown. The objectives of this study were to examine long-term outcomes and implant survival in elderly patients undergoing TEA for Fracture. Methods Patients from a previously published randomized controlled trial of 42 patients in which TEA was compared with open reduction–internal fixation (ORIF) were followed up long term. Patients were aged 65 years or older with comminuted intra-articular Distal Humeral Fractures. Outcomes included patient-reported grading of function and pain, revision surgical procedures, and implant survival. Results Data were obtained for 40 patients, 15 treated with ORIF and 25 treated with TEA, with a mean follow-up period of 12.5 years for surviving patients and 7.7 years for deceased patients. The reoperation rate was 3 of 25 in the TEA group and 4 of 15 in the ORIF group (P = .39). Of the 25 patients with TEAs, only 1 required (early) revision arthroplasty; 7 were living with their original arthroplasty, and 15 died with a well-functioning implant in situ. Three were lost to follow-up. Conclusions TEA is an effective and reliable procedure for the treatment of comminuted Distal Humeral Fractures in the elderly patient. Our study reveals reliable implant long-term survival, with no patient requiring a late revision. For the majority of these patients, a well-performed TEA will give them a well-functioning elbow for life and will be the last elbow procedure required.
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functional outcome following surgical treatment of intra articular Distal Humeral Fractures through a posterior approach
Journal of Bone and Joint Surgery American Volume, 2000Co-Authors: Michael D Mckee, Emil H Schemitsch, Tracy L Wilson, Lucy Winston, Robin R RichardsAbstract:Background: While surgical repair is considered the standard of care of displaced intra-articular Distal Humeral Fractures, most investigators have assessed its results with use of surgeon-based and/or radiograph-based outcome measures. The purpose of our study was to determine the functional outcome of fixation of displaced intra-articular Distal Humeral Fractures with use of a standardized evaluation methodology consisting of objective testing of muscle strength and use of patient-based questionnaires (both limb-specific and general health-status questionnaires). Methods: We identified twenty-five patients (fourteen male and eleven female), with a mean age of forty-seven years, who had an isolated, closed, displaced, intercondylar, intra-articular Fracture of the Distal part of the humerus repaired operatively through a posterior approach and fixed with plates on both the medial and the lateral column. All patients returned for follow-up that included recording of a complete history, physical examination, radiographic examination, completion of both a limb-specific questionnaire (Disabilities of the Arm, Shoulder and Hand [DASH]) and a general health-status questionnaire (Short Form-36 [SF-36]), and objective muscle-strength testing. Results: The mean duration of follow-up was thirty-seven months (range, eighteen to seventy-five months). The mean flexion contracture was 25 degrees (range, 5 to 65 degrees), and the mean arc of flexion-extension was 108 degrees (range, 55 to 140 degrees). Significant decreases in mean muscle strength compared with that on the normal side were seen in both elbow flexion measured at 90 degrees (74 percent of normal, p = 0.01) and elbow extension measured at 45 degrees (76 percent of normal, p = 0.01), 90 degrees (74 percent of normal, p = 0.01), and 120 degrees (75 percent of normal, p = 0.01). The mean DASH score was 20 points, indicating mild residual impairment. The SF-36 scores revealed minor but significant decreases in the role-physical and physical function scores (p = 0.01 and 0.03, respectively) but no alteration of the mental component or mean scores. Six patients (24 percent) had a reoperation; three of them had removal of prominent hardware used to fix the site of an olecranon osteotomy. Conclusions: The surgical repair of an intra-articular Distal Humeral Fracture is an effective procedure that reliably maintains general health status as measured by patient-based questionnaires. Our study quantified a decrease in the range of motion and muscle strength of these patients, which may help to explain the mild residual physical impairment detected by the limb-specific outcome measures and physical function components of the general health-status measures.